Hispanics slipping in medical coverage

Meanwhile, other minorities are closing the gap

WASHINGTON -- Hispanics are falling further behind whites in getting quality medical care, while other minority groups are closing the gap, federal officials said yesterday.

The areas where Hispanics were slipping include treatment for diabetes, mental illness, and tuberculosis. Officials also found growing gaps for Hispanics in getting regular dental visits for their children and speedy care for injury or illness.

Officials say they don't know why disparities in healthcare are growing for Hispanics but narrowing for blacks, Asians, and American Indians.

''The fact that we know it exists prompts a lot of local communities to say, 'What's going on here?' and to figure out also why it matters," said Carolyn Clancy, director of the Agency for Healthcare Research and Quality.

Clancy said people who have less access to care are more likely to be admitted to a hospital for a condition that could have been avoided, ''costing all of us a lot more money."

The government, using data mostly from 2002 and 2003, measured 40 types of disparities in the quality of healthcare between whites and minorities. Among blacks, 58 percent of those disparities were becoming smaller and 42 percent were becoming larger.

In contrast, among the disparities between whites and Hispanics, 41 percent were becoming smaller, while 59 percent were growing.

The government also measured access to healthcare. In all categories, disparities narrowed for blacks, Asians, and American Indians. But the gap worsened for Hispanics in five out of six categories, including access to health insurance.

Dr. Elena Rios, president and CEO of the National Hispanic Medical Association, said two out of five Hispanics don't have insurance, and that group contains both legal and illegal immigrants.

''Whole communities and families that come from Latin America, where they've had healthcare as a right, don't know you have to apply for insurance," she said.

Clancy cited a language barrier as one potential factor in healthcare disparities. The report showed that the quality of patient-provider communication as reported by patients declined among Hispanic adults (87 percent to 84 percent), even as it improved among white adults (93 percent to 94 percent).

Clancy said she did not know how much illegal immigration contributed to the growing gap. The data does not take the legal status of a patient into account.

''All of our data sources need a lot better information on subgroups of the Latino population, because we're lumping in obviously fairly different groups -- Mexican-Americans who have been here for a while as well as people who have immigrated more recently," she said.

Rios also called for granting illegal immigrants greater access to healthcare in the United States.

''Viruses and bacteria do not know borders," Rios said. ''It's about a humanistic perspective on being healthy."

Reports on the quality of healthcare as well as the disparities were issued yesterday as part of a conference sponsored by the Health and Human Services Department.

Overall, the quality of healthcare for all Americans improved at a rate of 2.8 percent, the same rate of increase shown in last year's report, Clancy said.